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Thymic epithelial tumor is a rare anterior mediastinal tumor. Surgery is the most important treatment for thymic tumors. However, non-surgical treatment is still an inevitable choice for unresectable advanced thymic tumors. The traditional treatment methods include chemotherapy and radiotherapy, but the effect is limited. With the development of immunotherapy therapy, some studies have attempted the exploration of immunotherapy for thymic tumors. Because of the low incidence rate of thymic tumors, these studies are mostly small retrospective analyses. This article review the clinical and basic research progress of immunotherapy for thymic tumors
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Drug metabolism and pharmacokinetics (DMPK) is an important branch of pharmaceutical sciences. The nature of ADME (absorption, distribution, metabolism, excretion) and PK (pharmacokinetics) inquiries during drug discovery and development has evolved in recent years from being largely descriptive to seeking a more quantitative and mechanistic understanding of the fate of drug candidates in biological systems. Tremendous progress has been made in the past decade, not only in the characterization of physiochemical properties of drugs that influence their ADME, target organ exposure, and toxicity, but also in the identification of design principles that can minimize drug-drug interaction (DDI) potentials and reduce the attritions. The importance of membrane transporters in drug disposition, efficacy, and safety, as well as the interplay with metabolic processes, has been increasingly recognized. Dramatic increases in investments on new modalities beyond traditional small and large molecule drugs, such as peptides, oligonucleotides, and antibody-drug conjugates, necessitated further innovations in bioanalytical and experimental tools for the characterization of their ADME properties. In this review, we highlight some of the most notable advances in the last decade, and provide future perspectives on potential major breakthroughs and innovations in the translation of DMPK science in various stages of drug discovery and development.
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Objective To use the cone-beam computed tomography(CBCT) to analyze the root number and root canal morphology of maxillary third molars in Luzhou area.Methods A total of 321 maxillary third molars in 200 outpatients in the stomatological hospital of Southwest Medical University from September 2016 to February 2017 were collected.The age,gender,root number,canal morphology and CBCT imaging data were recorded.The difference in root number of maxillary third molars between left and right sides and between genders were analyzed.Results In included 321 maxillary third molars,the root number was mainly fused root teeth(56.70%),followed by three roots teeth(26.48%);the number of root canal was mainly three root canals (38.94 %),followed by single root canal(30.84 %).According to the Vertucci root canal classification,65.73 % of root canals were type Ⅰ and 10.60% were type Ⅴ.There was no statistical differences between left and right sides(P>0.05),wherease there was statistically difference between genders(P<0.05).Conclusion The root number of maxillary third molars is variable,the root canal morphology has large variability and the root canal system is complex.
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Objective To summarize the treatment of 10 aortic coarctation cases ,who receive the surgery from ascending aorta to thoracic descending aorta with the prosthetic graft, discuss the valuable and appliable of this method. Methods Cardiac surgery, Chinese Acdemy of Medical Sciences, Peking Union Medical College Hospital department treated 10 patients who got the aortic coarctation from Jan. 2006 to Dec. 2015 Seven male patients and 3 cases of female patients consist of the sample, aged from 14 to 35 years old, the median age was 27. One cases consolidated aortic valve deformity and aortic root expansion, the others were simple aortic coarctation. Their upper limbs blood pressure was 20 mmHg higher compared with the low limb. Meanwhile, there was no sign of surgery contraindication. Ten cases received this operation under cardiopulmonary bypass situation. And the patient who consolidate aortic valve deformity and aortic root expansion receive the Bentall surgery at the same time. Results There was no death during perioperative time, no spinal cord ischemic and other serious complications. Those patients went back to outpatient department after discharging from hospital 3 to 6 months. The differential pressure between upperlimbs and low limbs were less than 20 mmHg, and the CTA results indicated no aneurysms. Conclusion Using artificial blood vessels to make a graft from the ascending aorta to the descending aorta is an effective method for treatment of thoracic aorta.
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Objective:To compare the expression and biological activity of glucosyl transferases (GTFs)of Streptococcus mutans (S.mutans)under normal outside environment between high temperature requirment serine proteinase A(HtrA)-deficient strains and high virulent strains isolated from children with high cario-susceptibility.Methods:The HtrA-deficient strains and high virulent strains of S.mutans were obtained by preliminary study.The strains were reanimated and incubated in BHI medium to exponential phase at tenth hour.The expression of gtfB,gtfC and gtfD were detected by real-time RT-PCR.The biological activity of the GTFs were detected by entong sulfuric acid method and Western Blot.Results:The expression of gtfs and GTFs in the HtrA-deficient strains was higher than those of high virulent strains,but the biological activity of the GTFs was lower.Conclusion:The HtrA gene plays an important regulatory role in the process of the GTFs expression of S.mutans isolated from children with high cario-susceptibility.
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Objective To systemically assess impact on postoperative outcomes after red blood cell transfusion(RBCT) in coronary artery bypass graft surgey.Methods A meta-analysis was performed on the comparison and synthesis of findings from included studies published from January 1980 to January 2014.Pooled odds ratio(OR) and 95 % confidence interval(CI) were calculated using RevManS.3 software.Sensitivity analysis was conducted and possible publication bias was tested as well.Results Seven retrospective studies including 71 228 patients(33 872 RBCT cases,37 356 control cases) were eligible for inclusion.The pooled analysis revealed difference in the 30-day mortality OR =1.85 (95% CI:1.35-2.54),1-year mortality OR =2.02 (95 % CI:1.44-2.84),shock OR =2.92 (95 % CI:1.96-4.35),renal dysfunction OR =7.67 (95 % CI:1.44-40.94),mediastinitis OR =2.26 (95 % CI:1.72-2.97),and myocardial infarction OR =3.53 (95 % CI:2.89-4.29).Conclusion Perioperative RBCT can incresase the risk of postoperative mortality and complications in coronary artery bypass graft surgey.High-quality randomized case cohort studies are still needed for the further proof of the risk.
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Objective To explore a method to culture human aortic valvular interstitial cells and identify the phenotypes,to establish the cell model which would be used to study aortic valve diseases in vitro.Methods Normal aortic valves of the patient with acute Stanford A aortic dissection in Peking Union Medical College Hospital were preserved during the surgical operation.Human aortic valvular interstitial cells were isolated and amplified in vitro by modified collagenase digestion method.The cell phenotype was identified by the immunofluorescent staining.Results Human aortic valvular interstitial cells could be successfully isolated and amplified in vitro by modified collagenase digestion method,identified by positive staining of Vimention and α-SMA.Conclusions The cell model of human aortic valvular interstitial ceils could be successfully established in vitro by modified collagenase digestion method.The cell phenotype identification proved to meet the experimental requirements.So it could provide cellular foundations for the study of pathogenesis of degenerative aortic valve disease.
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Objective To investigate the incidence of sharp injury (SI)among health care workers(HCWs)in dif-ferent levels of hospitals in Gansu Province,so as to improve HCWs’precaution awareness,standardize behavior, and provide guide for making occupational precaution measures.Methods From January to December 2012,HCWs in 38 medical institutes in Gansu Province were selected with stratified random sampling,HCWs were surveyed through questionnaires and interview.Results A total of 11 358 questionnaires were received,the incidence of SI was 9.87%(n=1 121),case rate was 12.60%(n=1 431),the frequency of SI was 1.05 times/(person·month).SI rates of different genders,positions and years of working were statistically different (all P <0.05).The main medical devices cau-sing SI were syringe needle,venous transfusion scalp needle and surgical suture .SI caused by known sources were 1 099 times (76.80%);980 times (68.48%)of SI were induced by contaminated sources,474 (48.37%)of which were blood-borne diseases,bloodborne disease exposure accounted for 33.12%.Among bloodborne disease exposure,hepatitis B virus accounted for 74.25%,Treponema pallidun 13.10%,hepatitis C virus 12.01% ,and human immunodeficiency virus 0.64%.Conclusion There is a high incidence rate of SI among HCWs in Gansu Province,it is a very important public health problem which needs to be solved.
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Inferior vena caval (IVC) tumor thrombus with cardiac extension is a very rare phenomenon,which proliferates fast and could be very challenging to the surgery.This paper was designed to investigate the clinical value of transesophageal echocardiography (TEE) for the surgical resection of IVC tumor thrombus extending into right cardiac cavities.Six cases from our medical institute,preoperatively diagnosed as IVC tumor thrombus with cardiac extension and scheduled for the surgical resection,were retrospectively analyzed.In addition to real-time and dynamic monitoring,comprehensive TEE exams were performed for all the patients respectively after anesthesia induction,namely before tumor resection and after tumor resection.Cardiac extension was defined by the preoperative finding of cardiac mass originated from IVC tumor thrombus by transthoracic echocardiography,computerized tomography or CT angiography.In all the cases,intraoperative TEE provided an accurate and excellent view of the IVC tumor thrombus.For case three,the IVC tumor thrombus was found at the IVC entrance to right atrium without further cardiac extension; for case five,the IVC tumor thrombus proliferated into right atrium but the extended cardiac mass was very slim and flexible and the tricuspid valve was untouched; for case four,the IVC tumor thrombus extended into right atrium and even cross the tricuspid valve but the extended cardiac mass was also very slim and flexible.Based on the TEE-provided information,the originally scheduled surgical decision was modified and the surgical resection was performed without cardiopulmonary bypass (CPB).For the other three cases,the intraoperative TEE showed similar results to preoperative findings.The huge IVC tumor thrombus extended into the right heart,presented almost no flexibility and dramatically compromised the intracardiac blood flow.For the three cases,CPB support was indispensable for the tumor resection.The full TEE exam after tumor resection in all the six patients displayed clear surgical resection without tumor residuals,but in those three patients suffered with severely compromised cardiac extension,severe tricuspid regurgitation was noticed.All the six patients were closely monitored until discharged,and no TEE-related complications were observed.This paper reports about TEE' s utilization in a series of consecutive patients undergoing surgical resection of IVC tumor thrombus with cardiac extension.In addition to its safety and effectiveness,TEE can provide valuable information for surgical decision making,surgical intervention assessment and anesthesiamanagement strategies.
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Objective:Through a study on knowledge, attitudes, and practice of tobacco control of medical staff in Gansu Province, the paper aims to analyze the issues of participation, community tobacco control leadership and other aspects that impact the creation of a smoke-free healthcare system in order to provide a basis for the formulation of policies to improve the health professional mechanism of tobacco control. Methods:The stratified cluster sampling method was adopted to select 34 companies, accounting for a total of 805 medical staff as the study population in all kinds of health institutions. A self-designed questionnaire was adopted to investigate their knowledge, attitudes, and practice via on-site self-administered surveys. Results:the medical staff lacks knowledge as to the depth and breadth of damage from the use of tobacco. Although their attitude towards tobacco control is positive, the comprehensive to-bacco control service capabilities are insufficient. Logistic regression analysis showed that tobacco control capabilities of medical staff is related to their attitude toward smoking and whether or not they discourage smoking or asking about smoking . Conclusion:The key to the creation of a smoke-free health system to lead the community in tobacco control is the targeted tobacco cessation knowledge and skills training of medical staff to reduce smoking rates among medical staff and enhance the awareness of administrative staff.
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Objective To evaluate the relationship between mRNA and protein expression of HtrA and Streptococcus mutans i-solated from the children with different caries experience and to provide the theoretical and experimental basis on prediction of dent-al caries in deciduous teeth .Methods The strains of Streptococcus mutans isolated from children with different carious experiences in the preliminary experiments were divided into three groups :high caries-susceptible group ,middle caries-susceptible group ,caries-free group .All strains were reanimated on the agar plate of MS ,and after smear pure culture examination ,typical bacteria were in-cubated in BHI ,then purified nucleic acid and extracted all the RNA of streptococcus mutans by reverse transcription PCR and de-tected it by agarose gel electrophoresis integrality .Synthetic cDNA and take further PCR amplification with cDNA products .Ob-serve records results by Gel imaging system .HtrA of target gene and electrophoresis image were gray scan by Gel quantitative soft-ware Gel-Pro analyzer 4 .0 was used to analyze relative expression value of gene .After purifying protein ,collected total protein of Streptococcus mutans strains by Western Blot method ,then tested the concentration of total protein sample .The results of Chemilu-minescence imaging were scanned into computer by Bio-Rad analyzing system ,calculated the gray value by software Quantity One 4 .4 .0 which showed the relative expression level of protein .Results There were significant differences in HtrA mRNA and protein expression of different Streptococcus mutans isolated from the children with different caries susceptibility .high caries-susceptible group> middle caries-susceptible group> caries-free group (P< 0 .05) .Conclusion There were significant differences in HtrA mRNA and protein expression of different Streptococcus mutans isolated from the children with different caries susceptibility .The higher caries susceptibility the group was ,the more HtrA mRNA and protein the strain express .
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ObjectiveTo research the relationship between the plasma levels of myeloperoxidase (MPO) and the onset and progress of acute coronary syndrome (ACS) and the severity of coronary lesions in patients with ACS.MethodsSeventy-eight patients hospitalized with chest pain were enrolled,including 41 patients with ACS (ACS group),17 patients with stable angina pectoris(SAP,SAP group) and 20 patients serving as control (control group).Forty-one patients undergoing coronary angiography were divided into single vessel lesions group (7 patients),double vessel lesions group (7 patients),multiple vessel lesions group ( 12 patients) and no vessel lesions group ( 15 patients) based on the vessel lesions of the left anterior descending,left circumflex artery and right coronary artery.According to the diameter stenosis of major coronary artery,there were 15 patients in no vascular stenosis group,2 patients in mild vascular stenosis group,6 patients in moderate vascular stenosis group and 18 patients in severe vascular stenosis group.The levels of MPO were measured by enzyme-linked immunosorbent assays(ELISA).ResultsThe levels of MPO in ACS group [( 252.10 ± 27.07 ) μ g/L]were higher than those in SAP group[( 185.81 ± 17.85 ) μ g/L]and control group [( 140.42 ± 71.40) μ g/L](P < 0.05 ),the levels of MPO in SAP group were higher than those in control group(P< 0.05 ).The levels of MPO in single vessel lesions group and multiple vessel lesions group were higher than those in no vessel lesions group (P < 0.05 ),but there was no significant difference among single vessel lesions group,double vessel lesions group and multiple vessel lesions group (P > 0.05 ).The levels of MPO in mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group were higher than those in no vascular stenosis group (P < 0.05),but there was no significant differenceamong mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group(P > 0.05 ).A positive correlation was observed between the levels of MPO and neutrophils (r =0.288,P=0.018 ),creatine kinase isoenzyme-MB(r =0.469,P=0.043 ),subject groups( r =0.757,P=0.000),vessel lesions (r =0.584,P=0.000) and the degree of vascular stenosis (r =0.491,P=0.001).Conclusion MPO may predict ACS and reflect the severity of coronary lesions in ACS as a novel inflammatory marker.
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To investigate the effect of casein phosphopeptide-amorphic calcium phosphate(CPP-ACP) on the growth of Lactobacillus fermentum and to evaluate the possibility of CPP-ACP as a biological anticariogenic agent. Lactobacillus fermentum was inoculated in BHI with different concentrations of CPP-ACP and grew in anaerobic condition at 37 ℃ for 48 h. Used MTT method to evaluate the effects of CPP-ACP on the growth of Lactobacillus fermentum. CPP-ACP inhibited the growth of Lactobacillus fermentum effectively. With the concentration of CPP-ACP increasing, the values of A(550 nm) decreased. It was found that CPP-ACP had inhibitory effect on the growth of Lactobacillus fermentum, the inhibitory effect increased with CPP-ACP concentration.
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Objective To explore the effects of temperature and relative humidity on radon exhalation rate of glazed tile in the hermetic environment. Methods Ordinary glazed tile was used as experimental object to detect radon concentration with Model 1027 continuous radon monitor in a 0.25 m3 simulation chamber at different temperature and humidity,and then calculated the radon exhalation rate. Results In reasonable range,a cubic correlation between radon exhalation rate(ER) and relative humidity(RH) expressed as ER=0.000 2RH3-0.040 2RH2+2.623 9RH-32.303(R2=0.986 6)was found; a cubic function relationship between radon exhalation rate(ER) and temperature(t) expressed as ER=-0.022 5t3+2.016 5t2-58.748t+565.05(R2=0.969 8)was also observed. Conclusion Environmental temperature and relative humidity have great effects on radon exhalation rate of glazed tile.
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Objective Renal tumor and gynecological tumor invading into inferior vena cava and extending to the right cardiac cavities is quite uncommon,we report the experience of diagnosis and surgical treatment of intravenous tumor embolus extending through inferior vena cava into the right cardiac cavities.Methods From Junuary 2001 to May 2008,4 patients with intravenous tumor embolus extending through inferior vena cava into right cardiac cavity were treated in PUMC Hospital.Three cases were leiomyomatosis.Two patients' operation was performed by stages,firstly removed tumer in the right cardiac cavities using cardiopulmonary bypass under mid-hypothermia,and,postoperatively 3~4 weeks,total abdominal hysterectomy with bilateral salpingo-oophorectomy including the tumor mass was performed.The other patient's tumor was resected at one time.One case is renal clear cell carcinoma,The urologist performed abdominal nephrectomy and then cardiac surgeon resected tumor embolus using cardiopulmonary bypass under deep hypothermic total circulatory.Results The four patients were uneventful recovery,there was no death or any serious perioperative complications.Following up of 3 months to 4 years showed no tumor recurrence after the operation.Conclusion Confirmed diagnosis,the tumor embolus extending through inferior vena cava into the right cardiac cavities should be suspected among patients with renal cell carcinoma and multiple hysteromyoma are all critical for the treatment.Successful therapy for intravenous tumor embolus is dependent on totalone or two-stage surgical excision of the tumor and multi-department cooperation and combined therapy.
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Objective To summarize the experience of great saphenous vein (GSV) harvesting using multiple interrupted cutaneous incisions and retrospectively compare the clinical results with those using traditional single long incision. Methods One hundred and forty-nine patients for initial elective coronary artery bypass grafting underwent GSV harvesting by either interrupted incisions (Group A, n=108) between August 2004 to October 2005 or traditional technique (Group B, n=41) between February 2004 and July 2004, respectively. The Length of GSV harvested, total incision length, time of harvesting, and complication rate were compared between the two groups. Results There were no statistical differences in the age, sex, length of GSV harvested, and macroscopic GSV quality between the two groups. Short- or long-term complications relating to the quality of venous grafts occurred in neither groups. As compared with the Group B, the Group A presented significantly longer time for GSV harvesting (49.3?6.6 min vs 29.1?5.4 min; t=17.490, P=0.000), shorter incision length (17.8?3.2 cm vs 43.1?4.9 cm; t=-36.878, P=0.000), and lower wound-related complication rate [9.3% (10/108) vs 22.0% (9/41); ?2=4.303, P=0.038]. The time for donor site manipulation was slightly increased in the Group A (62.4?8.7 min vs 59.8?6.9 min; t=1.718, P=0.088). Conclusions GSV harvesting using multiple interrupted incisions requires more complicated and difficult techniques than using a single long incision, but it is less invasive and produces superior patient satisfaction and better cosmetic outcomes.
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Objective: To investigate the acidogenicity and aciduric ability of Streptococcus mutans isolated from the children with different caries susceptibility.Methods: The acidogenic and aciduric ability of Streptococcus mutans strains isolated from children was investigated.Acidogenicity ability was compared among high caries-susceptible group,middle caries-susceptible group and caries-free group.Results: The acidogenicity and aciduric ability of Streptococcus mutans isolated from the high caries-susceptible children and middle caries-susceptible group were significantly higher than that isolated from caries-free group(P
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Objective: To investigate the inhibitory effect of Flu or Protector on the demineralization of bovine enamel caused by some beverages. Methods: Forty bovine teeth were equally divided into experimental and control groups, each of them were subdivided into two groups. The enamel sp ecimens of the experimental group were pretreated with Fluor Protector and then exposed to carbonated drinks and fruit juice respectively,the enamel specimens o f control group were exposed to beverages directly. All the enamel specimens wer e exposed to beverages 5 times a day and for 5 minutes each time. After 7- day exposure,the concentration of calcium and phosphate in the beverages were measu red by EL 312e Micro-Plate. Results: The concentration of calci um and phosphate in the corresponding beverage of experimental group was lower t han that in control group in the same expossure time(P0.05).Conclusions: Fluor Protector can inhibit the demineralization of bovin e enamel caused by beverages.The inhibitory effect of Fluor Protector decreases as the exposure time prolonges.
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0.05). The average amount of ammonia emission was 0.012%, 0.024% and 0.081% at pH values of 9, 11 and 13 respectively. Ammonia emission increased with the increasing pH values, especially for those admixtures containing carboxylate. Conclusion Ammonia emission from concrete admixtures sold in Lanzhou exceed the standard in different degree.Higher pH value may accelerate the ammonia emission from concrete admixtures and cause higher concentration of ammonia in indoor air.
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Objective To observe the removal of Cr(Ⅵ) and effects of some factors in solution on Cr(Ⅵ) with zero valent iron(ZVI).Methods A certain amount ZVI were added in a 50 ml solution with Cr(Ⅵ),the effects on removal ratio were observed when the initial Cr(Ⅵ) concentration was 5,10,20 and 30 mg / L,temperatures was 5,15,25 and 35 ℃,the ZVI dosage was 0.25,0.5,0.75,1.0,1.25 and 1.50 g and anions such as Cl-,NO3-,SO42-,CO32-and PO43-.The removal ratio of Cr(Ⅵ) was evaluated by Cr(Ⅵ) concentration difference pre and post-treatment with ZVI.Results Cr(Ⅵ) could be removed effectively with ZVI and removal ratio of Cr(Ⅵ) could reach over 90% in 5 min,the Cr(Ⅵ) concentration of the solution could meet the requirement of GB5749-2006 Sanitary Standard for Drinking Water Quality [ Cr(Ⅵ) concentration≤0.05 mg/L].The best reaction conditions was 35 ℃,pH=2,dosage of ZVI =1.0 g.Conclusion Cr(Ⅵ) can be removed by ZVI in solution,the removal ratio can be impacted by some factors such as pH value,Cr(Ⅵ) initial concentration,temperature.